MED SURG FINAL HESI
OBJECTIVE ASSESSMENT - EXAM
Med Surg Final Hesi 2026/2027
Actual Exam All Questions And
Well Elaborated Answers
Updated Version || Complete A+
Guide
Board Certification Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
* Cardiac Dysrhythmias & ECG Interpretation * Stroke & Seizure Disorders
* Respiratory Failure & Ventilator Management * Diabetes Mellitus & DKA Management
* GI Bleeding & Post-Operative Care * Shock, Sepsis & Multi-Organ Dysfunction
COVER PAGE - 1
, SECTION 1 | Foundations of Nursing Care | Q1-Q20 | Med Surg Final Hesi 2026/2027 Actual Ex...
Q1 Question 1 of 100
A 68-year-old male is admitted with a stage III pressure ulcer on his sacrum. The nurse
notes purulent drainage, erythema, and a foul odor. Which nursing intervention is the
priority?
A. Apply a hydrocolloid dressing to promote autolytic debridement
B. Obtain a wound culture before initiating any topical treatment
C. Irrigate the wound with sterile normal saline and apply a foam dressing
D. Place the patient on a low-air-loss mattress and reposition every 4 hours
Correct Answer: B
Rationale:
Obtaining a wound culture is the priority because the presence of purulent drainage, erythema, and foul odor strongly
suggests infection. Identifying the causative organism guides appropriate antibiotic therapy. While wound irrigation and
specialty mattresses are important, they are secondary to diagnosing the infection.
Q2 Question 2 of 100
A nurse is caring for a postoperative patient who had abdominal surgery 8 hours ago. The
patient reports increasing incisional pain rated 8/10 and has not yet passed flatus. Which
assessment finding warrants immediate notification of the surgeon?
A. Absence of bowel sounds in all four quadrants
B. Serous drainage on the surgical dressing measuring 2 cm
C. Heart rate of 102 beats per minute and blood pressure of 110/68 mmHg
D. Rigid, distended abdomen with absent bowel sounds and tachycardia
Correct Answer: D
Rationale:
A rigid, distended abdomen with absent bowel sounds and tachycardia are classic signs of peritonitis or bowel
obstruction, which are surgical emergencies requiring immediate intervention. Absent bowel sounds alone in the early
postoperative period can be normal, and serous drainage is expected.
Med Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score
, Q3 Question 3 of 100
A 72-year-old female with a history of heart failure is admitted with worsening dyspnea and
3+ pitting edema in both lower extremities. The nurse is reviewing her medication list and
notes she takes furosemide 40 mg daily at home. Which laboratory value should the nurse
monitor most closely before administering the next dose?
A. Blood urea nitrogen (BUN) level
B. Serum potassium level
C. Hemoglobin and hematocrit
D. Serum creatinine level
Correct Answer: B
Rationale:
Furosemide is a loop diuretic that causes significant potassium wasting through the kidneys. In a patient with heart
failure receiving diuretic therapy, hypokalemia is a serious risk that can precipitate life-threatening cardiac
dysrhythmias. While BUN and creatinine are important, potassium is the most immediately critical value.
Q4 Question 4 of 100
A nurse is preparing to administer warfarin 5 mg PO to a patient with atrial fibrillation. The
patient's INR is 4.2. Which action should the nurse take?
A. Administer the medication as ordered and recheck the INR in 24 hours
B. Hold the dose and notify the healthcare provider immediately
C. Administer half the ordered dose and monitor for bleeding
D. Give the dose with vitamin K to counteract the elevated INR
Correct Answer: B
Rationale:
An INR of 4.2 is above the therapeutic range of 2.0-3.0 for atrial fibrillation and indicates an increased bleeding risk.
The nurse should hold the warfarin dose and notify the provider. Administering vitamin K is not a nursing decision and
requires a provider order.
Med Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score
, Q5 Question 5 of 100
A patient with type 2 diabetes mellitus has a fasting blood glucose of 248 mg/dL. The nurse
is teaching the patient about preventing long-term complications. Which statement by the
patient indicates a need for further teaching?
A. I should check my feet every day for cuts or sores
B. I can skip my insulin if my blood sugar is normal at bedtime
C. I need to keep my HbA1c below 7% to reduce complications
D. I should wear supportive shoes and avoid walking barefoot
Correct Answer: B
Rationale:
Skipping insulin based on a single normal reading demonstrates a dangerous misunderstanding of diabetes
management. Insulin regimens must be followed consistently as prescribed, regardless of occasional normal readings.
The other statements reflect accurate self-management practices.
Q6 Question 6 of 100
A nurse is caring for a patient who had a total hip arthroplasty 2 days ago. The patient is
now ambulating with a walker. Which instruction is most important for the nurse to reinforce
to prevent hip dislocation?
A. Keep the affected leg internally rotated when sitting
B. Avoid crossing the legs and keep the knees lower than the hips
C. Sleep on the operative side to promote healing
D. Bend forward at the waist to tie shoes
Correct Answer: B
Rationale:
After total hip arthroplasty, hip precautions include avoiding hip flexion beyond 90 degrees, avoiding adduction past
midline, and avoiding internal rotation. Keeping knees lower than the hips and not crossing legs prevents hip flexion
beyond 90 degrees and adduction, which are the primary mechanisms of posterior dislocation.
Med Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score
OBJECTIVE ASSESSMENT - EXAM
Med Surg Final Hesi 2026/2027
Actual Exam All Questions And
Well Elaborated Answers
Updated Version || Complete A+
Guide
Board Certification Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
* Cardiac Dysrhythmias & ECG Interpretation * Stroke & Seizure Disorders
* Respiratory Failure & Ventilator Management * Diabetes Mellitus & DKA Management
* GI Bleeding & Post-Operative Care * Shock, Sepsis & Multi-Organ Dysfunction
COVER PAGE - 1
, SECTION 1 | Foundations of Nursing Care | Q1-Q20 | Med Surg Final Hesi 2026/2027 Actual Ex...
Q1 Question 1 of 100
A 68-year-old male is admitted with a stage III pressure ulcer on his sacrum. The nurse
notes purulent drainage, erythema, and a foul odor. Which nursing intervention is the
priority?
A. Apply a hydrocolloid dressing to promote autolytic debridement
B. Obtain a wound culture before initiating any topical treatment
C. Irrigate the wound with sterile normal saline and apply a foam dressing
D. Place the patient on a low-air-loss mattress and reposition every 4 hours
Correct Answer: B
Rationale:
Obtaining a wound culture is the priority because the presence of purulent drainage, erythema, and foul odor strongly
suggests infection. Identifying the causative organism guides appropriate antibiotic therapy. While wound irrigation and
specialty mattresses are important, they are secondary to diagnosing the infection.
Q2 Question 2 of 100
A nurse is caring for a postoperative patient who had abdominal surgery 8 hours ago. The
patient reports increasing incisional pain rated 8/10 and has not yet passed flatus. Which
assessment finding warrants immediate notification of the surgeon?
A. Absence of bowel sounds in all four quadrants
B. Serous drainage on the surgical dressing measuring 2 cm
C. Heart rate of 102 beats per minute and blood pressure of 110/68 mmHg
D. Rigid, distended abdomen with absent bowel sounds and tachycardia
Correct Answer: D
Rationale:
A rigid, distended abdomen with absent bowel sounds and tachycardia are classic signs of peritonitis or bowel
obstruction, which are surgical emergencies requiring immediate intervention. Absent bowel sounds alone in the early
postoperative period can be normal, and serous drainage is expected.
Med Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score
, Q3 Question 3 of 100
A 72-year-old female with a history of heart failure is admitted with worsening dyspnea and
3+ pitting edema in both lower extremities. The nurse is reviewing her medication list and
notes she takes furosemide 40 mg daily at home. Which laboratory value should the nurse
monitor most closely before administering the next dose?
A. Blood urea nitrogen (BUN) level
B. Serum potassium level
C. Hemoglobin and hematocrit
D. Serum creatinine level
Correct Answer: B
Rationale:
Furosemide is a loop diuretic that causes significant potassium wasting through the kidneys. In a patient with heart
failure receiving diuretic therapy, hypokalemia is a serious risk that can precipitate life-threatening cardiac
dysrhythmias. While BUN and creatinine are important, potassium is the most immediately critical value.
Q4 Question 4 of 100
A nurse is preparing to administer warfarin 5 mg PO to a patient with atrial fibrillation. The
patient's INR is 4.2. Which action should the nurse take?
A. Administer the medication as ordered and recheck the INR in 24 hours
B. Hold the dose and notify the healthcare provider immediately
C. Administer half the ordered dose and monitor for bleeding
D. Give the dose with vitamin K to counteract the elevated INR
Correct Answer: B
Rationale:
An INR of 4.2 is above the therapeutic range of 2.0-3.0 for atrial fibrillation and indicates an increased bleeding risk.
The nurse should hold the warfarin dose and notify the provider. Administering vitamin K is not a nursing decision and
requires a provider order.
Med Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score
, Q5 Question 5 of 100
A patient with type 2 diabetes mellitus has a fasting blood glucose of 248 mg/dL. The nurse
is teaching the patient about preventing long-term complications. Which statement by the
patient indicates a need for further teaching?
A. I should check my feet every day for cuts or sores
B. I can skip my insulin if my blood sugar is normal at bedtime
C. I need to keep my HbA1c below 7% to reduce complications
D. I should wear supportive shoes and avoid walking barefoot
Correct Answer: B
Rationale:
Skipping insulin based on a single normal reading demonstrates a dangerous misunderstanding of diabetes
management. Insulin regimens must be followed consistently as prescribed, regardless of occasional normal readings.
The other statements reflect accurate self-management practices.
Q6 Question 6 of 100
A nurse is caring for a patient who had a total hip arthroplasty 2 days ago. The patient is
now ambulating with a walker. Which instruction is most important for the nurse to reinforce
to prevent hip dislocation?
A. Keep the affected leg internally rotated when sitting
B. Avoid crossing the legs and keep the knees lower than the hips
C. Sleep on the operative side to promote healing
D. Bend forward at the waist to tie shoes
Correct Answer: B
Rationale:
After total hip arthroplasty, hip precautions include avoiding hip flexion beyond 90 degrees, avoiding adduction past
midline, and avoiding internal rotation. Keeping knees lower than the hips and not crossing legs prevents hip flexion
beyond 90 degrees and adduction, which are the primary mechanisms of posterior dislocation.
Med Surg Final Hesi 2026/2027 Actual Exam All Questions And Well Elaborated Answers Updated Version || Complete A+ Guide - 2026/2027 | Passing Score
